Residency Training with MD only or with CRNAs as relief/support

[DocOk]

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I am curious to find out from those in practice and current residents what their experience was during/after training under each model and which they feel is better. It seems like that most residency programs have gone to the CRNA as support for education model. With this there are times that attending is working with a resident and a CRNA to get cases done. Does this better suit the resident to understand the dyamics of staffing multiple rooms or limit his education intraoperatively/postoperatively? Not attempting to start an argument about CRNAs utility in anesthesia. Thanks.

 

[kazuma]

We have a few CRNA's during the daytime hours, but we relieve them if their room is still going at 5pm. They aren't allowed to place invasive lines or blocks and they generally do easy cases on ASA1-2 patients in the GI lab, ortho, washouts etc. At my program there isn't any competition with the CRNA's and if we see they are assigned to a case that seems interesting we can usually swap. Our VA is another story and I have observed competition with residents for cases over there as the VA CRNA's are allowed to do everything including blocks, lines and cardiac cases. As a med student I rotated at a couple programs that also trained SRNA's and competition can be variable depending on the case load of the institution.

 

[R-35]

In our program, having CRNAs allow us to be relieved at decent times if not on call, before 4-5PM, allowing for time to studying etc. If on call, we finish whatever cases are still going past 8-9PM sometimes 11PM, depending on coverage. We have a few rotations that we get to be a board runner and supervise 4 rooms. In other rotations we have no CRNAs, all cases covered by residents. Both have their pros and cons, I like that we are exposed to both models.

-JBL